Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial

doi:10.1136/bmj.324.7351.1430

BMJ 2002;324:1430 ( 15 June )

Primary care

Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial

Daniel Wight, senior researcher, ^a Gillian M Raab, professor, ^b Marion Henderson, senior researcher, ^a Charles Abraham, professor, ^c Katie Buston, senior researcher, ^a Graham Hart, professor, ^a Sue Scott, professor. ^d

^a Medical Research Council Social and Public Health Sciences Unit, Glasgow G12 8RZ, ^b Applied Statistics Group, School of Mathematics and Statistics, Napier University, Edinburgh EH11 4BN, ^c School of Social Sciences, University of Sussex, Arts Building E, Falmer, Brighton BN1 9SN, ^d Department of Sociology and Social Policy, University of Durham, Durham DH1 3JT

Correspondence to: D Wight danny{at}msoc.mrc.gla.ac.uk

Objective: To determine whether a theoretically basedsex education programme for adolescents (SHARE) delivered by teachersreduced unsafe sexual intercourse compared with currentpractice.
Design: Cluster randomised trial with follow up twoyears after baseline (six months after intervention). A processevaluation investigated the delivery of sex education and broaderfeatures of eachschool.
Setting: Twenty five secondary schools in eastScotland.
Participants: 8430 pupils aged 13-15 years; 7616 completedthe baseline questionnaire and 5854 completed the two year followupquestionnaire.
Intervention: SHARE programme (intervention group)versus existing sex education (controlprogramme).
Main outcome measures: Self reported exposure to sexually transmitteddisease, use of condoms and contraceptives at first and most recentsexual intercourse, and unwantedpregnancies.
Results: When the intervention group was compared withthe conventional sex education group in an intention to treatanalysis there were no differences in sexual activity or sexualrisk taking by the age of 16 years. However, those in the interventiongroup reported less regret of first sexual intercourse with mostrecent partner (young men 9.9% difference, 95% confidence interval $-$ 18.7 to $-$ 1.0; young women 7.7% difference, $-$ 16.6 to 1.2). Pupilsevaluated the intervention programme more positively, and theirknowledge of sexual health improved. Lack of behavioural effectcould not be linked to differential quality of delivery ofintervention.
Conclusions: Compared with conventional sex education thisspecially designed intervention did not reduce sexual risk takinginadolescents.

What is already known on this topic
Despite the widespread assumption that sex education delivered by teachers can reduce sexual risk taking in young people, there have been few randomised trials large enough to show this and none in the United Kingdom

Several quasi-experimental studies have concluded that sex education is effective, but most randomised trials suggest it is not

What this study adds
Improvements in teacher delivered whole class sex education have some beneficial effect on the quality of young people's sexual relationships but do not influence sexual behaviour

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